Publications by authors named "Fiona Walter"
Introduction: People from minoritised ethnic groups are diagnosed with dementia later in the disease. We explored pathways that may determine the timing of diagnoses in a UK ethnically diverse, urban area.
Methods: We conducted 61 semi-structured interviews: 10 community-dwelling older people from minoritised ethnic backgrounds with diagnosed and undiagnosed dementia (mean age = 72 years; males = 5/10), 30 family members (51; 10/30), 16 health or social care professionals (42; 3/15), 3 paid carers and 2 interpreters for people with dementia.
Background: Migrants face barriers accessing healthcare, risking delays in cancer diagnosis. Diagnostic delays result in later stage diagnosis which is associated with poorer cancer survival. This review aims to compare the differences in cancer stage at diagnosis between migrants and non-migrants.
View Article and Find Full Text PDFIntroduction: Identifying cancer earlier can help save lives. An increasingly popular approach to diagnosing cancer earlier is in the development of risk prediction models to be applied to the electronic healthcare record of patients. Development of these models requires systematic and thorough identification of the risk factors that might increase an individual's propensity to develop the disease.
View Article and Find Full Text PDFBiomarkers suitable for early detection of intrathoracic cancers in primary care: a systematic review.
Cancer Epidemiol Biomarkers Prev
October 2024
Intrathoracic cancers, including lung cancer, mesothelioma, and thymoma, present diagnostic challenges in primary care. Biomarkers could resolve some challenges. We synthesized evidence on biomarkers performance for intrathoracic cancer detection in low-prevalence settings.
View Article and Find Full Text PDFObjectives: To explore the potential impacts of incorporating prebiopsy magnetic resonance imaging into primary care as a triage test within the prostate cancer diagnostic pathway.
Subjects And Methods: Decision analytic modelling with decision trees was utilised for this early economic evaluation. A conceptual model was developed reflecting the common primary care routes to diagnosis for prostate cancer: opportunistic, asymptomatic prostate-specific antigen (PSA) screening or symptomatic presentation.
Article Synopsis
- Multifactorial cancer risk prediction tools like CanRisk are being increasingly used in healthcare, but effectively communicating this risk information is challenging for healthcare professionals.
- A 13-month co-design process involved patients, the public, and healthcare professionals to develop a new CanRisk report after receiving feedback on the original.
- The revised report presents key information for individuals and healthcare professionals, including summaries, explanatory text, and visual aids, enhancing communication around cancer risk management.
Background: Cardiovascular preventive strategies are guided by risk scores with unknown validity in cancer cohorts.
Objectives: This study aimed to evaluate the predictive performance of 7 established cardiovascular risk scores in cancer survivors from the UK Biobank.
Methods: The predictive performance of QRISK3, Systematic Coronary Risk Evaluation 2 (SCORE2)/Systematic Coronary Risk Evaluation for Older Persons (SCORE-OP), Framingham Risk Score, Pooled Cohort equations to Prevent Heart Failure (PCP-HF), CHARGE-AF, QStroke, and CHADS-VASc was calculated in participants with and without a history of cancer.
Article Synopsis
- The study investigates sex-specific factors that lead to advanced-stage diagnosis in bladder and renal cancer patients, using data from over 1,500 cases in England between 2012 and 2015.
- Female patients and those presenting with urinary tract infections or abdominal symptoms showed significantly higher odds of being diagnosed with advanced-stage bladder cancer compared to their male counterparts.
- The findings suggest that non-haematuria symptoms indicate a higher risk for advanced bladder cancer, highlighting the need for targeted interventions for women to address sex-related disparities in cancer outcomes.
Background: Hematuria is a cardinal symptom of urinary tract cancer and would require further investigations.
Objective: To determine the ability of renal bladder ultrasound (RBUS) with the Hematuria Cancer Risk Score (HCRS) to inform cystoscopy use in patients with hematuria.
Design, Setting, And Participants: The development cohort comprised 1984 patients with hematuria from 40 UK hospitals (DETECT 1; ClinicalTrials.
Background: Magnetic resonance imaging (MRI) of the prostate is a new, more accurate, non-invasive test for prostate cancer diagnosis.
Aim: To understand the acceptability of MRI for patients and GPs for prostate cancer diagnosis.
Design And Setting: Qualitative study of men who had undergone a prostate MRI for possible prostate cancer, and GPs who had referred at least one man for possible prostate cancer in the previous 12 months in West London and Devon.
Article Synopsis
- Australian guidelines suggest that individuals aged 50-70 should consider low-dose aspirin to lower colorectal cancer risk; this study aimed to assess whether a research consultation improves informed decision-making about aspirin use compared to a general prevention brochure.
- Conducted at six general practices in Victoria, Australia, between October 2020 and March 2021, the study randomized 261 participants, comparing a decision aid consultation with a standard CRC prevention discussion.
- Results showed that 17.7% of the intervention group made informed choices about taking aspirin by the first month, compared to 7.6% in the control group; however, at the six-month mark, aspirin uptake between the two groups was similar with 10.2% in the
Article Synopsis
- The study investigates prescription patterns leading up to diagnoses of renal and bladder cancer to identify potential early warning signs for timely investigations.
- Analyzing data from patients diagnosed between 2012 and 2015 in England, researchers focused on prescriptions related to urological symptoms and infections up to two years before the diagnosis.
- Findings revealed that UTI prescriptions notably increased nine months prior to cancer diagnoses, indicating a critical window for earlier diagnosis, especially in females with bladder cancer.*
Background: The early detection and diagnosis of cancer to reduce avoidable mortality and morbidity is a challenging task in primary health care. There is a growing evidence base on how to enable earlier cancer diagnosis, but well-recognised gaps and delays exist around the translation of new research findings into routine clinical practice. Implementation research aims to accelerate the uptake of evidence by health care systems and professionals.
View Article and Find Full Text PDFCancer affects one in two people in the UK and the incidence is set to increase. The UK National Health Service is facing major workforce deficits and cancer services have struggled to recover after the COVID-19 pandemic, with waiting times for cancer care becoming the worst on record. There are severe and widening disparities across the country and survival rates remain unacceptably poor for many cancers.
View Article and Find Full Text PDFArticle Synopsis
- * 44 participants, aged 40 and older, were interviewed, revealing that familiarity with similar tests and perceived cancer risk influenced their experiences; most found FIT straightforward and were willing to recommend it.
- * Communication regarding test results and next steps was inconsistent, as some patients received no feedback, leading to uncertainty about continuing care after a negative result.
Background: The CanRisk tool enables the collection of risk factor information and calculation of estimated future breast cancer risks based on the multifactorial Breast and Ovarian Analysis of Disease Incidence and Carrier Estimation Algorithm (BOADICEA) model. Despite BOADICEA being recommended in National Institute for Health and Care Excellence (NICE) guidelines and CanRisk being freely available for use, the CanRisk tool has not yet been widely implemented in primary care.
Aim: To explore the barriers to and facilitators of the implementation of the CanRisk tool in primary care.
Article Synopsis
- Prostate cancer mortality rates are significantly higher in Black males, necessitating a better understanding of their pre-diagnosis experiences and factors delaying help-seeking.
- A qualitative study examined the symptom appraisal and help-seeking behaviors of 18 males (nine Black and nine White) in London who recently consulted their GP for potential prostate cancer symptoms.
- Findings indicated that many patients downplayed symptoms, with Black males particularly affected by lack of awareness and cultural stigmas regarding health discussions, suggesting targeted interventions are needed to improve early detection.*
Article Synopsis
- Patients with bladder and kidney cancer often face delays in diagnosis, leading to missed opportunities for timely care.
- A study conducted in Eastern England identified patterns of suboptimal care, revealing that many patients with urinary tract infections (UTIs) were not referred for further evaluation, even when they met guidelines for suspected cancer.
- Qualitative interviews highlighted significant barriers in the diagnostic process, including inadequate examinations and poor communication, particularly affecting older female patients.
Context: Prebiopsy magnetic resonance imaging (MRI) of the prostate has been shown to increase the accuracy of the diagnosis of clinically significant prostate cancer. However, evidence is still evolving about how best to integrate prebiopsy MRI into the diagnostic pathway and for which patients, and whether MRI-based pathways are cost effective.
Objective: This systematic review aimed to assess the evidence for the cost effectiveness of prebiopsy MRI-based prostate cancer diagnostic pathways.
Article Synopsis
- Lung cancer is the leading cause of cancer-related deaths in the USA, and this study investigates how electronic health records (EHRs) can help identify symptoms that may indicate lung cancer before diagnosis.
- Researchers conducted a case-control study with 698 lung cancer patients and 6,841 control patients, analyzing EHR data from two years prior to diagnosis to find common symptoms linked to lung cancer.
- The study found eleven symptoms that were significantly associated with lung cancer, with seven of those being notably present six months before diagnosis, highlighting the potential for earlier detection and improved diagnostic practices.
Objectives: To evaluate incident cardiovascular outcomes and imaging phenotypes in UK Biobank participants with previous cancer.
Methods: Cancer and cardiovascular disease (CVD) diagnoses were ascertained using health record linkage. Participants with cancer history (breast, lung, prostate, colorectal, uterus, haematological) were propensity matched on vascular risk factors to non-cancer controls.